Hallucinations

by Oliver Sacks

eight “pseudopatients” with no history of mental illness presented themselves at a variety of hospitals across the United States. Their single complaint was that they “heard voices.” They told hospital staff that they could not really make out what the voices said but that they heard the words “empty,” “hollow,” and “thud.” Apart from this fabrication, they behaved normally and recounted their own (normal) past experiences and medical histories. Nonetheless, all of them were diagnosed as schizophrenic (except one, who was diagnosed with “manic-depressive psychosis”), hospitalized for up to two months, and prescribed antipsychotic medications (which they did not swallow).

In the popular imagination, though, hallucinatory voices are almost synonymous with schizophrenia—a great misconception, for most people who do hear voices are not schizophrenic.

Julian Jaynes, in his influential 1976 book, The Origin of Consciousness in the Breakdown of the Bicameral Mind, speculated that, not so long ago, all humans heard voices—generated internally, from the right hemisphere of the brain, but perceived (by the left hemisphere) as if external, and taken as direct communications from the gods. Sometime around 1000 B.C., Jaynes proposed, with the rise of modern consciousness, the voices became internalized and recognized as our own.

(Music calls upon many more areas of the brain than any other activity—one reason why music therapy is useful for such a wide variety of conditions.)